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The Promise of Health Care Reform for People with Mental Health and Substance Use Disorders *********************** Shel Gross, MPA Director of Public Policy. Mental Health America of WI. We’ve been asking to be treated as first class citizens; ACA does that. -National Council webinar.

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Mental Health America of WI

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Mental health america of wi

  • The Promise of Health Care Reform for People with Mental Health and Substance Use Disorders

  • ***********************

  • Shel Gross, MPA

  • Director of Public Policy

Mental Health America of WI


The bottom line

We’ve been asking to be treated as first class citizens;

ACA does that.

-National Council webinar

The Bottom Line


Private insurance regulation

Private Insurance Regulation

  • No pre-existing condition

    exclusions

  • Guaranteed issue

  • Premiums can’t be based on health status

  • Plans offered on exchanges must include MH/SA benefits at parity


Integration

Growing recognition that we can’t bend the cost curve without addressing chronic health conditions

And

We can’t address chronic health conditions without addressing mental health

Integration


Integration1

Integration

  • State option for “health homes” for people with SMI; 90% federal funding for 2 years.

  • Post-partum depression campaign.

  • Centers for Excellence on Depression.

  • Prevention services at no cost include depression and substance use screening.


Medicaid exchanges

Medicaid/Exchanges

  • Allows expansion of Medicaid to 133% FPL with enhanced federal funding.

  • Allows Medicaid to cover non-disabled adults without dependent children.

  • Along with formation of

    exchanges can reduce the

    uninsured by more than half.


Largest share of expansion pop are childless adults

Largest share of Expansion Pop. Are ‘Childless Adults’


Prevalence of behavioral health conditions among uninsured adults ages 18 64 with incomes 400 fpl

Prevalence of Behavioral Health Conditions Among Uninsured Adults Ages 18-64 with Incomes <400% FPL


Mh sa prevalence in the medicaid expansion pop

MH/SA Prevalence in the Medicaid Expansion Pop.

SAMHSA Data: see citation


Mh sa prevalence in the exchange population

MH/SA Prevalence in the Exchange Population


Will the promise be realized

Will the Promise Be Realized?


Status of medicaid expansion

Status of Medicaid Expansion

  • 27 states currently not moving forward or still debating Medicaid expansion.

  • If they don’t expand an estimated 6.4 million fewer people would gain coverage.

  • This represents nearly two-thirds of the potential reduction in the uninsured tied to the expansion.

    Analysis prepared by the Urban Institute for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured


Status of medicaid expansion1

Status of Medicaid Expansion


Status of exchanges

Status of Exchanges


Outreach challenge

Outreach Challenge

  • Even in States with expanded coverage, research has shown that individuals with MH or SU conditions remain disproportionately likely to be uninsured.

  • According to Massachusetts Bureau of SA Services 20-25% of acute service presentations (primarily detox) are uninsured. These are disproportionately young men who are otherwise physically healthy.


Citations

Citations

  • MH/SA Prevalence Data: 2008-2011 National Survey of Drug Use and Health; 2011 American Community Survey.

  • State Exchange Map: National Academy of State Health Policy.


Contact info

Contact Info

Shel Gross

Mental Health America of WI

608-250-4368

[email protected]


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